Clinical variations of the paroxysmal hemicranias

Are there different clinical variations of the paroxysmal hemicranias?

Yes. Although there has been controversy regarding the nomenclature of the PH, there appear to be three related forms:

  • • Chronic paroxysmal hemicrania (CPH), in which multiple headaches occur daily for years on end without remission or with remission periods of less than 1 month
  • • Episodic paroxysmal hemicrania (EPH), in which there are discrete phases characterized by frequent daily attacks separated by long-term, pain-free remissions
  • • Pre-CPH, in which an initially episodic form of these headaches ultimately evolves into the chronic unremitting form

Some authors prefer alternative nomenclature. At present, only CPH and EPH are recognized in the International Headache Society’s diagnostic system, as outlined in the third edition of the International Classification of Headache Disorders (ICHD III beta).


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